Remote ischemic conditioning in intensive care: From bench to bedside.

Area of Science:

• Cardiovascular Medicine
• Critical Care Medicine
• Physiology

Background:

• Ischemia/reperfusion (I/R) injury causes significant organ damage in critical conditions like myocardial infarction and stroke.
• It results from oxidative stress, inflammation, and mitochondrial dysfunction following blood flow restoration.
• Remote ischemic conditioning (RIC) is a non-invasive method to mitigate I/R injury.

Purpose of the Study:

• To review the historical context and underlying mechanisms of RIC.
• To examine the efficacy of RIC in preclinical and clinical studies across various I/R injury models.
• To discuss ongoing research for optimizing RIC delivery and patient stratification.

Main Methods:

• Narrative review of existing literature.
• Analysis of preclinical animal models demonstrating RIC's protective effects.
• Evaluation of clinical trial data assessing RIC's impact on patient outcomes.

Main Results:

• Preclinical studies consistently show RIC attenuates I/R injury.
• Clinical trials report variable outcomes, with limited effects on major clinical endpoints.
• RIC's protective effects are mediated by systemic molecular and cellular mechanisms.

Conclusions:

• RIC holds therapeutic potential for I/R injury but requires further investigation.
• Optimizing RIC protocols and identifying suitable patient populations are crucial for clinical translation.
• Future research should focus on refining RIC delivery and understanding patient-specific responses.